| NPI | 1346547288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 278797) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 57538) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2015-09-28 |